MEDICARE: DR. BRITT ASHLEY THEDINGER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YX0901X	Otology & Neurotology Physician	18188	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3274	OTHER	NE	BCBS
3	1000035	OTHER		UNITED HEALTH CARE

General Provider Information

NPI Number	:	1801895826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRITT ASHLEY THEDINGER M.D.

Provider Business Mailing Address
First Line	:	9202 WEST DODGE ROAD
Second Line	:	SUITE 200
City	:	OMAHA
State	:	NE
Zip	:	68114-3318
Country	:	US
Telephone Number	:	402-933-3277
Fax Number	:	402-933-2216

Provider Business Practice Location Address
First Line	:	9202 WEST DODGE ROAD
Second Line	:	SUITE 200
City	:	OMAHA
State	:	NE
Zip	:	68114-3318
Country	:	US
Telephone Number	:	402-933-3277
Fax Number	:	402-933-2216

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	08/12/2010

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